The Legacy of Chattel Slavery and Its Association with Prostate Cancer Incidences in the Southeastern United States

Present-day disparities in prostate cancer outcomes are a direct result of major historical events, such as chattel slavery. Few studies have evaluated the association between the legacy of historical racism and prostate cancer, a disease with a wide health disparity globally. In this study, we assess the relationship between county-level historical chattel slavery in 1860 and prostate cancer incidences in 2018 among Black and White individuals.

Prostate cancer incidences, socioeconomic variables, and 1860 slave data were all obtained from publicly available datasets. Our primary exposure was county-level density of enslaved people in 1860. Our primary dependent variable was prostate cancer incidence per 100,000. We used Poisson log-linear regression models to estimate the difference in county-level cancer counts per 10% increase in enslaved individuals in a county, adjusting for age and numerous social determinants of health.

County-level density of enslaved people correlated with various present-day social determinants of health. In our multivariable adjusted model, increased county-level enslaved populations in 1860 were independently associated with a significant increase in 2018 county-level prostate cancer incidences for both White and Black individuals.

Our results indicate that the presence of county-level chattel slavery was significantly associated with poorer present-day social determinants of health and increased prostate cancer incidences, regardless of race.

Addressing health inequities requires the acknowledgment of the role historical chattel slavery plays in health disparities affecting marginalized and low socioeconomic communities in America.